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Observational Study
. 2024 Aug 3;31(6):taae037.
doi: 10.1093/jtm/taae037.

Tuberculosis among children visiting friends & relatives

Tomas M Perez-Porcuna  1 , Antoni Noguera-Julian  2 , Maria Teresa Riera-Bosch  3 , Esperança Macià-Rieradevall  4 , José Santos-Santiago  5 , Maria Àngels Rifà Pujol  6 , Maria Eril  7 , Lídia Aulet-Molist  8 , Emma Padilla-Esteba  9 , Maria Teresa Tórtola  10 , Jordi Gómez I Prat  11 , Anna Vilamala Bastarras  12 , Josep Sebastià Rebull-Fatsini  13 , Andrea Papaleo  14 , Neus Rius-Gordillo  15 , Alessandra Q Gonçalves  16 , Àngels Naranjo-Orihuela  17 , Marta Urgelles  18 , Mónica G García-Lerín  19 , Gemma Jimenez-Lladser  20 , Beatriz Lorenzo-Pino  21 , Mónica Adriana Giuliano-Cuello  22 , Maria Teresa Pascual-Sánchez  15 , Mónica Marco-García  23 , Rosa Abellana  24 , Maria Espiau  25 , Maria Nieves Altet-Gómez  26 , Angels Orcau-Palau  27 , Joan A Caylà  28 , Antoni Soriano-Arandes  25
Affiliations
Observational Study

Tuberculosis among children visiting friends & relatives

Tomas M Perez-Porcuna et al. J Travel Med. .

Abstract

Background: Most paediatric tuberculosis (TB) cases in low-TB-incidence countries involve children born to migrant families. This may be partially explained by trips to their countries of origin for visiting friends and relatives (VFR). We aimed to estimate the risk of latent TB infection (LTBI) and TB in children VFR.

Methods: We conducted a prospective multicentric observational study in Catalonia (Spain) from June 2017 to December 2019. We enrolled children aged < 15 years with a negative tuberculin skin test (TST) at baseline and at least one parent from a high-TB-incidence country, and who had travelled to their parent's birth country for ≥21 days. TST and QuantiFERON-TB Gold Plus (QFT-Plus) were performed within 8-12 weeks post-return. LTBI was defined as a TST ≥5 mm and/or a positive QFT-Plus.

Results: Five hundred children completed the study, equivalent to 78.2 person-years of follow-up (PYFU). Thirteen children (2.6%) were diagnosed with LTBI (16.6/per100 PYFU, 95%CI = 8.8-28.5), including two cases (0.4%) of TB (2.5/per100 PYFU, 95%CI = 0.3-9.3). LTBI incidence rates remained high after excluding BCG-vaccinated children (9.7/per100 PYFU, 95%CI = 3.9-20.0). Household tobacco smoke exposure was associated with LTBI (aOR = 3.9, 95%CI = 1.1-13.3).

Conclusions: The risk of LTBI in children VFR in high-TB-incidence countries may equal, or perhaps even exceed, the infection risk of the native population. The primary associated risk factor was the presence of smokers in the household. Furthermore, the incidence rate of active TB largely surpassed that of the countries visited. Children VFR in high-TB-incidence countries should be targeted for diagnostic and preventive interventions.

Keywords: Tuberculosis; children; epidemiology; latent TB infection; visiting friends and relatives.

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Figures

Figure 1
Figure 1
Flowchart showing the patients invited to participate in the study, enrolled in the study and finally included in the analysis. Abbreviations: TST: Tuberculin Skin Test
See this image and copyright information in PMC

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